DISCREPANCY BETWEEN SELF-REPORTED AND ACTUAL CALORIC-INTAKE AND EXERCISE IN OBESE SUBJECTS
DISCREPANCY BETWEEN SELF-REPORTED AND ACTUAL CALORIC-INTAKE AND EXERCISE IN OBESE SUBJECTS
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DOI：
10.1056/nejm199212313272701
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发表时间：
1992-12-31
影响因子：
158.5
通讯作者：
HEYMSFIELD, SB
中科院分区：
文献类型：
--
作者：
LICHTMAN, SW;PISARSKA, K;HEYMSFIELD, SB
研究背景和方法。一些肥胖的受试者一再未能减轻体重，尽管他们报告将卡路里的摄入量限制在每天1200千卡以下。我们在224名连续接受治疗的肥胖症受试者中，研究了这种明显的饮食抵抗的两种解释--总能量消耗低和卡路里摄入少报。第一组包括9名女性和1名男性，有饮食抵抗史，我们通过间接量热法和身体成分分析评估了14天的总能量消耗及其主要生热成分和实际能量摄入量。第二组包括67名女性和13名男性，均无饮食抵抗史。饮食抵抗者(第1组)的总能量消耗和静息代谢率均在身体成分预测值的5%以内，食物和运动的热效应在第1组和第2组之间无显著差异。因此，低能量消耗被排除为自我报告饮食抵抗的机制。相比之下，第一组的受试者平均少报了他们的实际食物摄入量(+/-SD)47%+/-16%，多报了他们的体力活动51%+/-75%。虽然第一组受试者没有明显的精神病理特征，但他们认为肥胖有遗传原因，频繁使用甲状腺药物，并将他们的饮食行为描述为相对正常(均P
Background and Methods. Some obese subjects repeatedly fail to lose weight even though they report restricting their caloric intake to less than 1200 kcal per day. We studied two explanations for this apparent resistance to diet - low total energy expenditure and underreporting of caloric intake - in 224 consecutive obese subjects presenting for treatment. Group 1 consisted of nine women and one man with a history of diet resistance in whom we evaluated total energy expenditure and its main thermogenic components and actual energy intake for 14 days by indirect calorimetry and analysis of body composition. Group 2, subgroups of which served as controls in the various evaluations, consisted of 67 women and 13 men with no history of diet resistance.Results. Total energy expenditure and resting metabolic rate in the subjects with diet resistance (group 1) were within 5 percent of the predicted values for body composition, and there was no significant difference between groups 1 and 2 in the thermic effects of food and exercise. Low energy expenditure was thus excluded as a mechanism of self-reported diet resistance. In contrast, the subjects in group 1 underreported their actual food intake by an average (+/-SD) of 47+/-16 percent and overreported their physical activity by 51+/-75 percent. Although the subjects in group 1 had no distinct psychopathologic characteristics, they perceived a genetic cause for their obesity, used thyroid medication at a high frequency, and described their eating behavior as relatively normal (all P